Patient Activation Measures Among Individuals With Epilepsy: A Cross-Sectional Study of an Arabic-Speaking Population.

Abstract

Objectives: To examine patient activation levels among Arabic-speaking adults with epilepsy and to explore their associations with selected clinical and sociodemographic variables.

Methods: We conducted a cross-sectional study of 109 adult patients with confirmed epilepsy between December 2023 and October 2025. Data were collected during outpatient clinic visits, with additional information obtained through telephone contact when necessary. A sample size estimate indicated that at least 96 participants were required to achieve 80% statistical power. Patient activation was assessed using the validated Arabic version of the 13-item Patient Activation Measure (PAM-13). The variables examined included seizure type, medication regimen (monotherapy versus polytherapy), employment status, and medication adherence. Self-reported adherence was categorized as high or low based on patient responses regarding medication-taking behavior. Statistical analyses were performed using SPSS version 27. PAM scores were compared across relevant groups using appropriate bivariate statistical tests, and a p value <0.05 was considered to indicate statistical significance.

Results: The mean PAM score was 66.2 ± 17.6, corresponding to a moderate level of activation. Most participants (86.2%) demonstrated activation levels of 3 or 4. Focal epilepsy was more common (62.4%) than generalized epilepsy was (37.6%). Monotherapy was used by 51.4% of the participants, and 77.1% reported high medication adherence. Compared with unemployed or retired participants, employed individuals had significantly higher PAM scores (72.0 vs. 60.0, p<0.01). Greater adherence was also associated with greater activation (p<0.01). No significant associations were observed between PAM scores and seizure types or treatment regimens.

Conclusion: Most patients demonstrated moderate to high activation levels. Employment status and medication adherence were positively associated with activation, suggesting potential targets for interventions aimed at improving self-management among individuals with epilepsy.